James G Mondo, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1221 Issued in MN

Practice address

1310 Highway 96 E
Suite #102
White Bear Lake, MN 55110-3624

Phone

(651) 429-0304

Fax

(651) 429-8326

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Birch Lake Chiropractic Clinic, LLC

  • Chiropractor
  • White Bear Lake, MN
  • NPI 1255407136
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891887451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 HIGHWAY 96 E",
            "address_2": "SUITE #102",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103624",
            "telephone_number": "651-429-0304",
            "fax_number": "651-429-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 HIGHWAY 96 E",
            "address_2": "SUITE #102",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103624",
            "telephone_number": "651-429-0304",
            "fax_number": "651-429-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONDO",
        "first_name": "JAMES",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26186MO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minnhealth Family Physicians, P.a.
• Kimberley M Mintell, DC
• Mitchel V. Mondo, Inc.
• Mary Catherine Mohr, DO
• Momenta Mental Health
• Mitchel Vincent Mondo, D.C.
• Mackenzie Monty
• Michele Moore, MN CHID #2729
• Jason Moua, RPH
• Tony Kong Moua, PHD

• All providers in White Bear Lake, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.